Broberg, Raven

Broberg, Raven is an individual health care provider with primary practice located at 1530 1St Ave N Ste 150 , Moorhead MN 56560-0002. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Broberg, Raven can be contacted via phone (218) 275-6602.

Contact Information

Primary practice address
1530 1St Ave N Ste 150 Moorhead MN 56560-0002
Phone: (218) 275-6602
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X

Profile Details

NPI number 1003573510
LBN Legal business name Broberg, Raven
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 18th, 2021
Last updated Jul 26th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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